Senate Republicans Keep Struggling to Reach Agreement on Health Care Overhaul

Republican leaders in the U.S. Senate are struggling to find a way to revive their effort to overhaul the country's health care law, but so far have not reached agreement among fractious wings of the party on how it ought to be reshaped.

Several Republicans met late into Wednesday, looking for ways to replace the Affordable Care Act, commonly called Obamacare — a reference to former President Barack Obama, during whose first term it was approved.

President Donald Trump had told GOP senators earlier in the day they should stay in Washington through their normal August recess until they reached agreement to repeal and replace the law.

Republican Senate leader Mitch McConnell of Kentucky said he would call a vote next week on repealing the law without replacing it, but also could call for a vote on a repeal-and-replace measure. Several Republicans have announced their opposition to even starting debate on either of the bills, leaving McConnell short of a majority to move ahead.

The chamber's minority Democrats remain unified in their opposition to upending Obamacare.

At a White House lunch, Trump exhorted Republican senators to vote for the repeal, saying any Republican who voted against it was telling voters they were "fine with Obamacare." Republican lawmakers have called for repealing the law since 2010, when Democrats pushed it through Congress without a single Republican vote in favor of it.

Surveys reflect law's popularity

About 20 million Americans have gained insurance under the law, and national surveys show Obamacare is more popular than Republican proposals to replace it. The Congressional Budget Office said if that Obamacare was repealed without a replacement, 17 million Americans would lose their health insurance next year and 32 million by 2026. Under a Senate Republican replacement proposal, the CBO said 22 million would lose their health care insurance coverage to help pay medical bills in the next decade, but the plan would save the government $420 million.

With Republicans holding a 52-48 majority in the Senate, party leaders looking to repeal the law can lose the votes of only two Republican dissenters, with Vice President Mike Pence casting a vote in favor of the repeal in the event of a 50-50 tie.

Some Republican lawmakers opposing the repeal effort say the changes go too far in curbing insurance coverage under the government's health care program for impoverished people, while others say the party leaders' repeal plan does not go far enough to dismantle the Obama law.

Whatever their disagreements, Trump emphatically told the Republican lawmakers at Wednesday's lunch that they needed to keep their seven-year promise to voters to repeal and replace the law.

"There is no question that the president's meeting added a lot of momentum towards getting to a result," said Senator Bob Corker of Tennessee. "He handled it very well."

'No harm' seen in vote to repeal

McConnell said "no harm would be done" to simply repeal Obamacare, noting that a repeal would not take effect for two years and that the bill to scrap Obamacare could be amended at any time.

Senate Minority Leader Chuck Schumer said the CBO numbers bore out what Democrats have been saying: that a repeal is a "horrible idea" and would "devastate the American health care system."

Prior to the White House meeting, at least three Republican senators had said they would vote against starting debate on repeal-only legislation, and four said they would oppose debate on a bill to repeal and replace Obamacare. In both instances, that would be enough to kill the legislation in the 100-member chamber.

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